© 2007 European Society of Cardiology
Assessment of cardiac asynchrony by radionuclide phase analysis: Correlation with ventricular function in patients with narrow or prolonged QRS interval
a Division of Cardiology, Salvatore Maugeri Foundation IRCCS, Scientific Institute of Veruno (NO) Italy
b Nuclear Medicine Service, Salvatore Maugeri Foundation IRCCS, Scientific Institute of Veruno (NO) Italy
c Cardiology Department, Ospedale di Circolo Varese, Italy
d Nuclear Medicine Service, General Hospital Lugano (CH), Italy
* Corresponding author. Fondazione Salvatore Maugeri, IRCCS, Scientific Institute of Veruno, Cardiology Division, via Revislate 13, Veruno 28010 (No) — Italy. Tel.: +39 0322 884711; fax: +39 0322 830294. E-mail address: cmarcassa{at}fsm.it
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Abstract |
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Background: Conflicting data exist on the relation between the synchronism of cardiac contraction and ventricular function.
Aim and methods: A resting radionuclide ventriculography (RNV) was performed in 380 consecutive patients to evaluate the relationship between the synchronism of cardiac contraction and ventricular function.
Results: A significant, non-linear, relation was found between LVEF and intra-ventricular asynchrony or QRS, but not between inter-ventricular asynchrony and LVEF. A linear correlation was observed between QRS and intra-ventricular or inter-ventricular asynchrony. Intra-ventricular asynchrony was identified as the major, independent, determinant of LV function. With the increase in QRS duration, a decrease in LVEF (p<0.001), and a worsening of either intra-ventricular (p<0.001) or inter-ventricular synchronism (p<0.05), was documented. However, 48% of patients with QRS 120–150 ms had abnormal inter-ventricular and 42% abnormal intra-ventricular synchronism, while 27% of patients with QRS>150 ms had normal inter-ventricular and 25% normal intra-ventricular synchronism.
Conclusions: Intra-ventricular asynchrony was identified as the major determinant of ventricular dysfunction. A consistent proportion of patients had asynchrony despite preserved QRS duration or normal synchronism with a QRS>150 ms. Fourier phase analysis of RNV may detect asynchrony better than QRS. The role of RNV for detection of individual patients who may most benefit from resynchronization therapy requires additional investigations.
Key Words: Asynchrony • Heart failure • Phase analysis • Radionuclide ventriculography • Resynchronization • Ventricular function
Received March 27, 2006; Revised September 18, 2006; Accepted January 10, 2007
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